Stephon Nicholas

To­ba­go Cor­re­spon­dent

The Di­vi­sion of Health is ex­press­ing alarm over “high rates” of sex­u­al­ly trans­mit­ted in­fec­tions (STIs) in To­ba­go, par­tic­u­lar­ly HIV, among the 20-29 age group.

In an ex­clu­sive in­ter­view with Guardian Me­dia, Oni­ka Hen­ry, se­nior pro­gramme co­or­di­na­tor for sex­u­al health and youth de­vel­op­ment at the De­part­ment of Well­ness, Pre­ven­tion and Health Pro­mo­tion, said HIV in­fec­tions are ris­ing on the is­land. Apart from un­ac­cept­able HIV lev­els, Hen­ry said gon­or­rhoea and syphilis are al­so soar­ing on the is­land and glob­al­ly.

“We are mon­i­tor­ing those close­ly in To­ba­go be­cause it seems to be an in­ter­na­tion­al trend,” she said, adding there is a new drug-re­sis­tant strain of gon­or­rhoea.

“HIV re­mains a pri­or­i­ty be­cause those rates seem to be in­creas­ing over a num­ber of years. I re­mem­ber com­ing back in 2016 af­ter study­ing abroad; there was an in­crease hap­pen­ing even then.”

Hen­ry said while the STI trans­mis­sions re­main a big con­cern, she said the di­vi­sion is still analysing the da­ta to get a clear­er pic­ture.

“We’re see­ing an in­ter­est­ing pat­tern in terms of a par­tic­u­lar age group. From 20-29, they seem to have con­sis­tent­ly high rates when it comes to STIs. What we can’t do is draw any firm con­clu­sions about whether that means we have STIs in­creas­ing or whether more peo­ple are com­ing for­ward to be test­ed.”

She said da­ta from pri­vate in­sti­tu­tions re­mains in­ac­ces­si­ble to the di­vi­sion, but it is work­ing to ad­dress this.

Hen­ry, a clin­i­cal sex­ol­o­gist, said the main hin­drance to com­bat­ing new in­fec­tions is shame. She said the Di­vi­sion of Health is for­mu­lat­ing a work­place pol­i­cy to re­move dis­crim­i­na­tion and stig­ma sur­round­ing HIV. It al­so in­tends to strength­en pub­lic trust in their in­for­ma­tion re­main­ing con­fi­den­tial at pub­lic fa­cil­i­ties.

While HIV is now con­sid­ered a chron­ic dis­ease ow­ing to ad­vances in treat­ment, Hen­ry ac­knowl­edged it re­mains a tremen­dous fi­nan­cial bur­den on the di­vi­sion.

“It is not about us just want­i­ng peo­ple to be well and hav­ing a healthy labour force, but there is al­so the chal­lenge of bud­getary al­lo­ca­tions; the chal­lenge of find­ing fund­ing if you find your rates are in­creas­ing every year and if you have to pro­vide free med­ica­tion for a grow­ing pop­u­la­tion of pos­i­tive folks.”

She said there are com­pli­ca­tions in­volved in liv­ing with HIV, adding that an age­ing pop­u­la­tion that is not well is prob­lem­at­ic.

The sex ed­u­ca­tor be­lieves ear­ly in­ter­ven­tion and ed­u­ca­tion are key, stress­ing the im­por­tance of in­cor­po­rat­ing sex­u­al ed­u­ca­tion in­to the school cur­ricu­lum.

“Giv­en the num­bers, the STI re­ports we are hear­ing, it would be a grave in­jus­tice to not give young peo­ple the skills and knowl­edge they need to pro­tect them­selves. Sex­u­al­i­ty is health; it is part of one’s whole­ness and well­ness.”

Hen­ry said the in­ten­tion is to col­lab­o­rate with the Di­vi­sion of Ed­u­ca­tion to de­sign age-ap­pro­pri­ate mes­sages for chil­dren. While an­tic­i­pat­ing some re­sis­tance from re­li­gious groups, Hen­ry is ea­ger to get all stake­hold­ers in­volved, in­clud­ing var­i­ous par­ents’ and teach­ers ‘ as­so­ci­a­tions (PTAs).

“I am hope­ful that they would see, based on the fig­ures, num­bers and re­search, that what we have been do­ing is clear­ly not work­ing, and if we re­al­ly care about our young peo­ple’s health, that we would do some­thing about it in ways that are ev­i­dence-based.”

She be­lieves re­li­gious groups preach­ing ab­sti­nence should em­brace sex­u­al ed­u­ca­tion in schools from an ear­ly age.

“Ab­sti­nence is a skill, it is not a tal­ent we are born with. Ab­sti­nence and re­fusal skills are part of sex ed­u­ca­tion.”

She said, like all oth­er sub­jects in the cur­ricu­lum, there is a way for it to be taught in the class­room, even at the pri­ma­ry school lev­el.

She warned against judg­ing young peo­ple too harsh­ly and la­belling them reck­less when they are bom­bard­ed dig­i­tal­ly with sex­u­al con­tent.

“If your on­ly ac­cess to in­for­ma­tion about sex is porn, we are cre­at­ing a sit­u­a­tion where peo­ple are look­ing at ex­plic­it con­tent with­out know­ing how to eval­u­ate it, as­sess it and as­sum­ing this is the norm, copy­ing what they’re see­ing and caus­ing harm to them­selves and oth­ers.”

She said sex­u­al ac­tiv­i­ty among pri­ma­ry school stu­dents is al­so be­ing re­port­ed and in­ves­ti­gat­ed,

Hen­ry ar­gued that even chil­dren with dis­abil­i­ties must not be ex­clud­ed from be­ing ed­u­cat­ed on the top­ic.

As the is­land pre­pares for its fifth an­nu­al car­ni­val in Oc­to­ber, the di­vi­sion will be rolling out an aware­ness pro­gramme tar­get­ing young peo­ple.

She said in­flu­encers will be in­clud­ed as they meet the pop­u­la­tion at the var­i­ous fetes and oth­er ac­tiv­i­ties to spread their mes­sage.

IDA head hits pub­lic-pri­vate sec­tor dis­con­nect

Mean­while, Dr Denise Tsoisafatt An­gus, med­ical doc­tor and po­lit­i­cal leader, In­no­v­a­tive De­mo­c­ra­t­ic Al­liance (IDA), said it was a trav­es­ty that the di­vi­sion was un­able to ac­cess da­ta from the pri­vate sec­tor.

“The pub­lic health sec­tor in To­ba­go should be con­nect­ed to the pri­vate doc­tors for them to re­port on what they are see­ing. They should be able to give the pub­lic sec­tor a re­port, month­ly or week­ly, on the cas­es they are see­ing. So if there is an uptick in the num­bers, the pub­lic health sec­tor should start in­creas­ing their ed­u­ca­tion.”

She said this dis­con­nect could eas­i­ly be bridged by a pol­i­cy from the THA.

“It is just a pol­i­cy de­ci­sion and them go­ing out and en­gag­ing the pri­vate per­sons and cre­at­ing a re­port­ing sys­tem. I am sure the doc­tors in the pri­vate sec­tor would be more than hap­py to give a re­port, even though they’re not giv­ing the names of their pa­tients.”

She said health is­sues of such mag­ni­tude should not be treat­ed in iso­la­tion.